Massengill, Lolita Condino

Massengill, Lolita Condino is an sole proprietor health care provider with primary practice located at 6665 Banbury Road , Jacksonville FL 32211. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Gerontology, which is considered as her primary health care specialty. Massengill, Lolita Condino can be contacted via phone (904) 745-9333.

Contact Information

Primary practice address
6665 Banbury Road Jacksonville FL 32211
Phone: (904) 745-9333
Fax: (904) 743-0046
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X ARNP2007072 Florida

Profile Details

NPI number 1871581660
LBN Legal business name Massengill, Lolita Condino
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 6th, 2005
Last updated Mar 22nd, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871581660 NPPES
Florida MEDICAID 300697200

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